What Is an ACL Tear? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Treatment for an ACL tear can include rehabilitation, followed by surgery.

Whether surgery is required to repair a tear in the anterior cruciate ligament depends on a variety of factors including:

• Your activity level and expectations of how active you want to be
• The type of work you do
• Whether or not cartilage, ligaments, and other parts of the knee are also injured

Some people who are elderly or inactive may choose not to have surgery, if they can return to limited activity after rehabilitation, or by wearing a brace.

Younger people who want to maintain an active lifestyle or return to competitive sports are more likely to opt for surgery.

People who decide not to have reconstructive surgery may experience further injury to the unstable knee joint.

Reconstruction surgery is the most common technique used to treat a torn ACL. During this surgery, the torn ACL is replaced with a new ligament taken from a donor or from one of your other tendons around the knee. (Donor ligaments come from those who are no longer alive but chose, when living, to give their body to help others.)

Once a graft is chosen, the surgeon will perform arthroscopic surgery, making small incisions in the leg and inserting a pencil-shaped instrument that holds a camera called an arthroscope, as well as other tools. As time goes on, the new graft becomes a living ligament in your knee.

Physical therapy is an important part of recovery that includes stretching, balancing, and strength-training exercises.

After surgery, you’ll most likely participate in a physical therapy program for 6 to 12 months, depending on your tear and the level of activity you want to reach.

If you’re an athlete, rehabilitation may take longer to get you in physical condition to participate in your sport or activity.

The first part of physical therapy will focus on returning proper range of motion to the ACL joint and the muscles that surround it, including the quadriceps and hamstrings.

Once this is achieved, you’ll be given a strengthening program that focuses on increasing stress across the ligament.

In the last phase of rehabilitation, your physical therapist will assess which activities, if any, still create pain, discomfort, or instability in your knee joint, and will establish ways to work around such activities. It’s important to know that early return to play after ACL repair has been associated with an increased risk of re-tears and repeat injuries.

Related: Telemedicine for Physical Therapy: It Works! 

Prevention of ACL Tears

While some ACL injuries are not preventable, the following may help minimize your risk for future tears:

• Strength training to develop strong thigh and hamstring muscles
• Maintaining a stretching routine with your legs
• Thoroughly warming up before playing sports, including jogging backward as a part of a warm-up routine
• Learning to land on the balls of your feet rather than flat-footed